Stjrgucal chair



(No Model.)

' E. BONNEFOY.

SURGICAL GHAIB..

Patent 4 Sheets-Sheet 1.

' Aug.. 1o, 1886..

by@ my Q (No Model.) I Lammsmi 2.

E. BONNBFOY. A

SURGIG'AL CHAIR. No. 347,024. Patented Augl 10. 1886.

- mvaNTnR; WITN'EssEYs.

N. PETERS, Pholvulhognphcr, Washington, D. C.

(No Mdel.)

E. BONNBPOY. 4 Sheets-Sheet SURGICAL CHAIR.

-INVENTDR;

W11' N asses g UNITED LSivifins- PATENT Grinch.;

EUGNE BONNEFOY, OF ROANNE, FRANCE.

SURGICAL CHAIR.

SPECIFICATION forming part of Letters Patent No. 347,024, dated August10, 1886.

Application filed July 27, 1883. Serial No. 102,095. (No model.)Patented in France August 2, 1881, No. 144,221 5 in England August Zi,1881, No. 3,395, and inBelgium December 12, 1882, No. 59,836.

To all whom it may concern,.-

Be it known that l', EUGNE BoNNEFoY, a citizen of the French Republic,and a resident of Roanne, (Loi re,) France,have invented eertain neivanduseful Improvements in Surgical Apparatus for the Treatment ofFractures,

Diseases of the Joints, dsc., of which the following is a specication.

Heretofore in the treatment of fractures,

coXalgies, and osseous regenerations it has' What I have said of plasteris equally true of all other methods of this character.

In my present invention I have sought to avoid the above inconveniencesby substituting for the mold or splint a mechanism Which offersimportant advantages.

By means of my apparatus I am enabled to fix immovably and in aninstantV the fractured or injured parts, so as to insure a perfectjoining of the fragments until complete consolidation is effected,pwiththe possibility of ilexing the joints Without the least reaction on theinjured parts.

My apparatus also provides, in addition to the holding of the osseousfragments in the axis of the member-,a means whereby the member may,according to requirement,be lengthened or shortened-that is to saythefractured parts, While being firmly held, may be moved toward or fromeach other. Free access may be had lto the injured part-at all times,and the progress of the healing and knitting noted.

Withmy apparatus I am able not only to treat simple fractures of themembers, but multiple fractures of the vertebral column and basin orpelvic region, as Well as osseous regenerations and coxalgies.

My apparatus comprises, in general, a litter provided with hinges whichcorrespond to the hip, knee, and and ankle joints of the patient, strapsto hold the members down firmly to the couch of the litter, mechanismfor varying the angles at the hinges, and mechanism for 'elongating andshortening the parts, all as will be hereinafter more fully described.

In the drawings, which serve to illustrate my invention, Figure l is aside elevation of my apparatus as adapted for use in general, andespecially for ambulance or outdoor use. Fig. l is a detached elevationof the box or cushion-receptacle I and its cushion, shown as lowered.Fig. 2 is a plan of the same. Fig. 3 is a side elevation similar to Fig.l, showing my apparatus for indoor use, provided with additionalconveniences for the patient, and Withcaste1s,whe1eby it may be wheeledabout conveniently. The main features of construction are the same asthose seen in Figs. l and 2. Figs. 4 to 25 are detached fragmentarydetail views, on a larger scale, that illustrate the working parts.These will be referred to more particularly hereinafter.

The base of my apparatus is a stout frame made of vsheet-steel, of Ushape in cross-scc tion, and comprising side rails, A A, connected bytransverse bars B B. The rails A are hinged at their middles at a. Figs.et and 5 show, respectively, a side elevation and a plan of the hinge.This hinging at the middle enables the frame to be folded forconvenience of transportation. The frame has legs C C, which are hingedto shorter legs b b, riveted to the rails A at c c. The legs C areconnected to the shorter legs b by means of clamping thumb-screws d d,as clearly shown in the two detached elevations, Figs. 6 and 7. rIlhelegs C are provided with feet of rubber D, as shown in Fig. l, orcasters D, as shown in Fig. 3. At the ends of the side rails, A, aremounted hinged or folding handles E E, for convenience in carrying thelitter. On this frame is hinged at a a, Figs. 1, 3, 4, and 5, themovable back F of the couch, the movement of which lon its hinges iseilected by mechanism (best seen in Figs. 8, 9, and 10) which arerespectively a longitudinal vertical section of rail A on line 8 8 inFig. 9, a plan of rails A A, and a transverse section on line 10 10 inFig. 8.

G is a linkbrace hinged at its upper end to the back F, and at its lowerend to a slide-nut, g, mounted on rail A.

T is a screw mounted in bearings in the hollow of the rail and engagingnut y.

'1" is a worm-wheel on the end of screw T.

r is a worm or screw mounted rotatively in the rail A, and engagingwheel 1", and f is a crank fixed on the axis of the worm 9'.

The operation of raising and lowering theA back F by means of the crankf will be readily understood. Fach side rail is provided alike, and thetwo worms 1' are on a shaft in common, which extends across the frame inthe hollow of the transverse bar B. \Vhen the patient reclines on thecouch, the hinging axis of the back F corresponds exactly with the axisof articulation of the hip-joints, and it is at this point also that Ihinge those parts of my apparatus which support the inferior members,and take the points of counter-extension which support the basin infront ou the rest lI. This rest is padded and fixed, and its shape maybe represented by a curved line litted in front to the ischions and thesuperior and inferior parts of the thighs, and by a right line whichtraverses the basin and passes through the axes ofthe hip'joints. Thehinge at the middle maintains the perfect symmetry of the two parts ofthe body by permitting the necessary play or :llexure at the hips. 1t isthis which gives me pelvic counter-extension-that is to say, theimmobilization of one of the fragments or parts to adapt it to theother, which otherwise would not be possible. The basin rests on a smallcushion or mattress, I', in a box or receptacle, l', which is hinged atone end between the rails A by means of arms 11., hinged on across-shaft, j", as seen in Figs. lt), 1 1, and 1.2, the former of whichare elevations and the latter a plan of the part. The cushion-box I issupported on straps 71. 71, attached at one end to the rest Ylf and atthe other end to the shaft; j, on which they are wound by rotating saidshaft through the medium of a crank, fi. The shaftj5 is provided with anordinary ratchet, '17', and pawl it, to prevent it from rotatingbackward inadvertently. l'y means of this supporting device the cushionl may bc raised or lowered for convenience in treating the patient.

For supporting the inferior members and forming a part of the couch, l.provide two concave supports, l( l, for the thighs, which arc hinged atu. (c, and are perfectly independent of each other. To these are hingedsimilar concave supports, L L, for the inferior portions of the legs,the hinges being at the knees. Fach leg-rest l( L rests on two points ofsupport. The part 1i is supported by the braee-link )l and the part Lbythebracelink N. The upper end of link Nis hinged direct ly to the restL at a, and the upper end of link M is connected indirectly (in a mannerthat will be hereinafter described) to the rest K at m.

Figs. 13, 14, and 15 illustrate themcchanism for raising and loweringthe rests 1i L, Fig. 13 being alongitudinalverti cal section through aside rail, A, Fig. 14- a sectional plan, and Fig. l5 a transversesection. The link M is controlled by a crank,j, and the link N by acrank, 7.'. The crank 7' bears on its axis or shaft two worms or screws,s s, which drive each a long screw, p, arranged in the hollow of a rail,A, through the medium of a worm wheel, s', one on each screw 7). Thescrews j in `turning cause to advance or retreat nuts s, connected by across-piece, sf, to which are hinged the lower ends of the links M. Theparts I have called nutszfc' are merely sliding boxes mounted in therails A A, andin each is rotatively mounted a sleeve-like nut, c" thefunctions of which will be hereinafter explained. The crank transmitsmovement to the screwsl through the medium of the worms Z' and theworm-wheels Z2. The nuts l are traversed by the screws Z, and as thesescrews are journaled in the rails A, (sce at the left in Figs. 1.3 and14,) it follows that the screws will drive the nuts l? back and forthalong the rails A. The crank ,7' and its axis or shaft arc mounted inthe nuts 1,),and the screws 11 have collared bearings in the sa me,consequently the screw lwill also, under certain conditions, hereinafterdescribed, impart motion to the nuts .2', as will be seen from inspection of Fig. 1,3. \Vhen the rests l( L have been properly adjusted, theparts may be lixed by turning the shaft ffl, through the medium ofthemilled head L". Theshalt el' has screwthreads c, which engage a femalescrew in a fixed nut, s", in the cross-piece s.

Ou the shaft are collars fr", arranged in pairs, (see Fig. 1.4,) andbetween each pair of collars the slotted lower ends ol' two plates, a,straddle the shaft c. The plates m' are pivoted or fulerumed in thesliding nut lata."l (see Fig. 15,) and by the movement of the screw backand forth the plates are made to oscillate. The upper ends ofthe platesare toothed to lit into the teeth of racks zu, fixed on the lower facesof the crowns of the rails A. \\`hen the teeth of plates ./v"Z are inengagement with the teeth of rack af, the parts above described arelocked fast to rails A, as seen in Fig. 15. The crank 7u cannot now beturned. As for the crank y',this can be turned, but the sleeve-nut c onscrew j), which is collarcd in the slide-nut c, turns with the screw,and no endwise movement is obtained. This sleevenut z" has teeth like along pinion, and on the plate is formed a projection or tooth, zi, (seeFig. 15,) which engages these teeth on the sleeve-nut when thc plate isnot in engagement with rack :ligand holds the nut from turning. \Vhcnthe plate fr is engaged with the rack, as in Fig. 15, the tooth al isout of engagement with the sleeve-nut and the latter will rotate withthe screwp. The side rails of the rests K are constructed telescopic, soas to be lengthened and shortened to suit the IIO requirements of thesurgeon. The part hinged at a has a'graduated bar, o, (see Fig. 1,)which slides in the side rail of the rest K.

The extension of the rest K is effected by the mechanism shown detachedand enlarged in Figs. 16, 17, and 18. Fig. 16 is a longitudinal sectionon line 16 16 in Fig. 18. Fig. 17 is a cross-section on line 17 17 inFig. 16, and Fig. 18 is a plan. This device is in the nature oftelescopic bars coupled at one end to the frame which supports the restH, (see Fig. 1,) and at the other end to leg-rest K L, where the twoparts are hinged together, and provided with screw'mechanism for slidingthe telescoping parts on each other.

Y Z is a hollow bar,` U-shaped in section. This bar is coupled to theleg-rest at the hinge, as seen in Fig. 1. In this bar Z slides anothersimilar bar, o', which is graduated on top, as seen in Fig. 18. This baris hinged to the frame which supports rest H. In the hollow of bar o isrotatively mounted a screw, p2, the thread on which engagesa thread in anut, p7,ixed to bar Z. On screw p2 is fixed a worm- Wheel, p",which isdriven, through a worm on Screw p5 from a crank, p', through suitablegear-wheels, p4. To the bar Z the links M are coupled at m.

The links N are constructed to be lengthened and shortened at will, asillustrated in Figs. 19 and 20, the former of which is a side elevationand the lattei` a crosssection. The part o2 slides telescopically intothe otherpart, and asetfscrew, o3, is employed to clamp the two togetherwhen properly adj usted.

The part L of the leg-rest is provided with means for varying itslength, which are similar to those before described. This constructionis illustrated in Figs. 21 and 22, the former being a longitudinalsection of one of the rails of the rest L and the latter across-section. The bar u* slides telescopically in L, and is graduated,as seen in Fig. 1.

On the crank-shaft t is a worm, u, which meshes with a worm-wheel, u, ona screw, u2, which is rotatively mounted in collared bearings in L. Thethread on this nut engages the thread in anut, u, fixed in bar u".

The operation will be readily understood.

The sandals or footrests O of the couch are hinged at y to the leg-restsL, and their inclination can be varied by means of slotted braces y2,hinged at their upper ends to the sandals, and secured to L at theirlower ends by set-screw or clamp-screw ys. In Fig. 23 I have shown oneof these sandals vO in front elevation.

In the more elaborate Vform of my apparatus (illustrated in Fig. 3) Ihave shown it provided with means whereby the patient may himself effectthe proper or desired adjustments, 'and also provided with otherconveniences that will be hereinafter described. Inthis form P is atubular sheath attached at its lower end to a rail, A, and projectingback to within reach of the patient. Vithin this sheath is mounted ashaft, Q, provided with a hand-wheel or crank, Q', on its upperprojecting end, and provided with a toothed wheel on its lower end,which meshes with a toothed wheel on the screw Z. This mechanism isshown clearly in the enlarged sectional view, Fig. 23a. Through thismechanism the patient is enabled to effect the rotation of screw Z. In asimilarly-arranged sheath, It, (see Figs. 3 and 24,) is mounted a shaft,R, which has a crank, S, on its upper end within reach of the patient.This shaft bears a toothed wheel, which meshes with another toothedwheel on the screw T, whereby the patient is enabled to raise or lowerthe back F.

U is a small table mounted on the litter at the side of the patient forhis convenience, and V V are cushion supports or rests for his arms.

Fig. 25 is a detached view showing rings x4,

arranged along the side rails of the back-rest F,`the leg-rests K L, andthe footrests O. Extending across the said rests from rail to rail, andattached by means of these rings, are, rst, an upper set of rubberbands, X X, next to the body of the patient, and, second, a set ofbands, X', below these, to support a mattress, on which the body of thepatient rests. When it is desired to remove the mattress for any reason,the bands X are drawn tight, when they will be firmly held by the gripof th'e attaching-rings, as clearly illustrated in Fig. 25. The lowerseries of bands, X, supporting the mattress, may now be slacked up andthe mattress lowered, leaving the patient resting for the time on thebands K. By this means the bedding on which the patient rests may beremoved from below and changed without disturbing his position. This isvery important in some cases. The bands or straps m2', for securing alimb in position,for example, are attached to the rings seen in Fig. 25.By the slacking or tightening of the bands X the body of the patient maybe raised or lowered at will. The rings so* are in couples, and theattachment of the band X01' X is made by passing the end of the band upthrough both rings, around the upper ring, and then back under the lowerring, whereby the said end is clamped between the ring and the band.This forms awell-known fasteninghitch, that will at once give way assoon as the band is slackened, but will hold its grip while there istension on the band. It will be seen that the body of the patient issuspended between the rails of the back F, and that the bar H supportsthe body against any endwise movement, especially when the back F isinclin ed. The cushion I forms a support for the buttocks and heavierpart of the body, and it may be lowered very conveniently to make roomfor a vessel or commode, when such is required.

I am enabled to provide my apparatus with all that is necessary fortreatment with irrigations without soiling the mattress, and to IOOemploy irrigation with phenol without touching the wound or member,which may be held iixed in au atmosphere of phenol vapor, as in renewingthe dressings or performing an operation.

The form of apparatus seen in Figs. l and 2 carries with it all theoperating parts. The cranks are under the control of the surgeon only,inorder that the position he gives to the patient may not be changedthrough ignorance. The cranks are made removable, so that the surgeonmay carry them in his pocket.

In Fig. l, y represents two rolls of some thin material which may beused to form an awning` to shade the patient on the battle-field or inthe open air. In forming a tent or awning of these one is placed on theother to insure warmth in cold weather. One is made impermeable orwater-proof, and this 011e is placed above. A light bow or frame,afghinged at a, and capable of being raised up or turned down, like acarriage-top,is employed to support the awning-cover. The sheets, whenstretched over the bow u, may be secured to the frame of the litter inany convenient way. The frame or bow will be held erect bythe fabricstretched over it.

The form of litter shown in Fig. S may also be provided with a bow,fu,to support an awning, if such is desired. At each end of the frame ofthe litter may be arranged lockboxes o r, Fig. l, to hold bandages, &c.,for the surgeons use.

In Figs. l and 3 the position of the bands X and X is indicated on theback F by dotted lines, and in Fig. 2 the bands X are shown in fulllines. It will be understood, however, that these bands are not,ordinarily, attached permanently to the couch.

Having thus described my invention, I claiml. The combination, with thestout frame of the apparatus hinged at its middle, a, for folding, ofthe adjustable couch mounted on said frame, and comprising the back F,hinged to the frame also at a, the' jointed leg-rests K L, hinged to theframe also at a, and means, substantiall y as described, for supportingsaid back and leg-rests in an inclined position, whereby the frame andcouch may be folded on a common hinge-axis, as described.

2. The back F and leg-rests K L of the couch, constructed of side railsand flexible bands, which latter hang down between the side rails, so asto bring the hinging-axis a coincident with the axis of the hip-joint ofthe patient, and the rigid curved rest or bar II, mounted as shown, andarranged to take under and support the upper portions of the thighs, asset forth.

3. The combination, with the back F,hinged at a t-o the main frame, andthe said main frame, of the screw T, mounted in bearings in the hollowrail A, the nut g on said screw, the link G, coupled at one end to theback and at the other end to said nut g, the worm-wheel 1" on said screwT, the worm 1, engaged with wheel 1", and the crank f on the axis ofsaid worm, all substantially as described.

4. The combination, with the main frame, of the boX I,hnged in the sameatits one end, its cushion I', the su] )porting-straps h h under saidcushion, the winding-shaft j, on which said straps are wound at theirone ends, the crank t', and the pawl and ratchet for preventing thebackward rotation of shaft j, substantially as set forth.

5. The combination, with the hollow rail A of the main frame, and thescrew Z, mounted therein, of the sheath P', fixed to rail A, the obliqueshaft Q, mounted in said sheath, and provided with a crank, Q', and theintermeshing gear-wheels on shaft Q and screw l, respectively, wherebythe patient may operate the said screw, as set forth.

6. The combination, with the hollow rail A of the main frame and thescrew T, mounted therein, of the sheath It, fixed to rail A, the obliqueshaft R,mounted therein, and the intermeshing gear-wheels on the shaft Rand screw T, respectively, whereby the patient may operate said screw,as set forth.

In witness whereof I have hereunto signed my name in the presence of twosubscribing witnesses.

EUGNE noNNEFoY.

Witnesses:

AUGUsTE BONNEFOY, VICTOR RIBOLET.

